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consideration in Dental Practice. Covid 19

consideration in Dental Practice. Covid 19 2. Contents: About the corona virus, prevalence, risk factors Introduction 01 General transmission, transmission by dental procedures. Mode of transmission 02 Diagnostic testsDiagnosis 03 Treatment protocols 04 05 Guidelines of prevention, prevention during dental treatment Preventive measures Drug used or treatment Introduction CHARACTERISTICSOF 2019 NOVEL CORONAVIRUS coronavirus to cross species to infect human populations in the past two decades. 1. Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) outbreak in 2002 2. Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak in 2012. Group of viruses : cause a significant percentage of all common colds in human adults and children. • Four human coronavirusPrevalence • Confirmed- 46,64,486 • Recovered- 17,08,969 • Deaths- 300,254 Worldwide: COVID-19 & Dentistry:Returning to Practice: A Walkthrough of the ADA’s Guidance & Aerosol Management transmissibility HOW doYOUget COVID-19? Cough,sneeze,and droplet inhalation transmission DIRECT TRANSMISSION Contact with oral, nasal, eye and mucous membrane INDIRECT TRANSMISSION 10. STRUCTUREOFVIRUS 11. How SARS-COV-2 BINDSTOTHE HUMAN CELL? 12. DENTAL AEROSOLIZATION 13. Dental procedures create particles ofdroplets and aerosol withCOVID-19 •Firstly, many dental procedures, such as those including the use of high-speed turbines and running water, release a large number of particles of droplets and aerosols mixed with the patient’s saliva to the air. INCUBATION PERIOD of COVID-19 has been estimated at 5 to 6 d on average. -The ASSYMPTOMATIC INCUBATION PERIOD for individuals infected with 2019-n Cov has been reported to be 1-14 days, Very high High Medium Low risk Healthcare workers, laboratory personnel, morgue workers performing autopsies Medical transport workers, Clinicalmanifestations PANDEMIC (COVID-19) Cough Fever Shortness Of Breath Sore Throat ● Atypical symptoms, such as muscle pain, confusion, headache ● Fatigue ● Diarrhoea and vomiting older age and the existence of underlying co- morbidities (e.g., diabetes, hypertension, and cardiovascular disease) were associated with poorer prognosis LaboratoryDiagnosis All symptomatic contacts of laboratory confirmed cases  All symptomatic health care workers  All patients with Severe Acute Respiratory Illness  Asymptomatic direct and high-risk contacts of a confirmed case should be tested once between day 5 and day 14 of coming in his/her contact. Throat and nasal swab Preferred sample • Nasopharyngeal swab, • Endotracheal aspirateAlternate: Samplecollection 22. Lower respiratory tract Bronchoalveolar lavage, tracheal aspirate, sputum Collect 2-3 mL into a sterile, leak-proof, screw-cap sputum collection cup or sterile dry container. Upper respiratory tract Nasopharyngeal swab / oropharyngeal swab wear appropriate PPE with latex free purple nitrile gloves while collecting Tilt patient’s head back 70 degrees.  Rub swab over both tonsillar pillars and posterior oropharynx Avoid touching the tongue, teeth, and gums. investigations RT - PCR Rapid Diagnostic Tests (RDTs) Rapid diagnostic tests based on Antigen Detection Rapid diagnostic tests based on host Antibody Detection Reverse transcriptase polymerase chain reaction (RT-PCR) RNA must first be converted to DNA using an enzyme called reverse transcriptase. For people anxiously waiting for their test results Viral proteins (antigens) expressed by the COVID-19 virus in a sample from the respiratory tract of a person. Chloroquine Presence of antibodies in the blood of people believed to have been infected with COVID-19  BCG is known to have in reducing the incidence of respiratory viral infections, its use during the COVID-19 pandemic may prove beneficial. Melatonin, a well-known anti-inflammatory and anti-oxidative molecule, Dentistry” During & After COVID-19 lockdown? How to REBOOTING The Dental Practice After lockdown? Duringlockdown 39. EmergencySeverityAssessment HowToPrevent AnOutbreak? droplet and aerosol transmission are significant risks in the dental practice setting. Step 1: TELEPHONIC PRESCREENING PROTOCOL • Fix appointments through phone only & Discourage Walk-in Patients Step 2: RECEPTION/ WAITING AREA PROTOCOL • Receptionist / Staff : One Person • Discourage footwear within clinic interiors/ provide foot cover • Record patient temperature using Digital Non-contact Infrared Thermometer • Mandatory use of Alcohol Based Hand Rub (ABHR) & provide Mask for everyone • Seating arrangement with minimum 3 feet Physical Distancing Step 3: DENTAL OPERATORY PROTOCOL • Keep the clinical operatory clutter-free • Improve air circulation and avoid air-conditioners • 0.01% NaOCl for disinfection of dental water lines Step 4 Pre-Procedural Mouth rinse: 1% Hydrogen peroxide or 0.2% Povidone-iodine : 1 min Step 5: PATIENT DISCHARGE • Patient advised to re-mask and proceed to reception area • Hand Hygiene • Electronic Treatment records only